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| Name | Class |
|---|---|
| Centers for Medicare and Medicaid Services | FED |
| General Services Administration (GSA) | FED |
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Fraud and waste is estimated to cost the American health care system nearly $200 billion each year, and the public Medicare and Medicaid programs about $60 billion each year. This study will evaluate a new method for fighting fraud: mailing informative letters to outlier providers to notify them of their aberrant behavior. These letters are targeted at high prescribers of schedule II controlled substances in Medicare Part D. The investigators will look at the effects of these letters on the behavior of providers and their patients. These effects are of substantial policy interest as they suggest how to best design anti-fraud policies. They are also of academic interest, shedding light on the behavior of physicians and their patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No informative letter | No Intervention | This is the control arm and it involves no contact with the prescriber | |
| Informative letter | Experimental | This is the treatment arm; prescribers in this arm receive an informative letter (called a comparative billing report or peer activity report) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Informative letter | Other | The intervention is a letter that describes the Schedule II prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers. |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day Equivalent Prescribing of Schedule II Controlled Substances | The prescribing of schedule II controlled substances over the 3 months following the initial sending of the letters. Prescribing is defined as the total "days supply" of schedule II controlled substances attributed to the prescriber, expressed in "30-day equivalents" i.e. divided by 30. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day Equivalent Prescribing of Schedule II Controlled Substances | 1 month | |
| 30-day Equivalent Prescribing of Schedule II Controlled Substances | 6 months | |
| 30-day Equivalent Prescribing of Schedule II Controlled Substances |
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Inclusion Criteria:
Exclusion Criteria:
- Deceased
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| Name | Affiliation | Role |
|---|---|---|
| Amy Finkelstein, PhD | Massachusetts Institute of Technology | Principal Investigator |
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| Label | URL |
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| American Economic Association Randomized Controlled Trials Registry Entry | View source |
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Seven of the identified outliers had died by the time of the study and were excluded from the intervention and later analysis.
There was no recruitment in the traditional sense. High prescribers of Schedule II controlled substances were identified in Medicare administrative data using a Tukey outlier method.
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| ID | Title | Description |
|---|---|---|
| FG000 | No Informative Letter | This is the control arm and it involves no contact with the prescriber |
| FG001 | Informative Letter | This is the treatment arm; prescribers in this arm receive an informative letter (called a comparative billing report or peer activity report) Informative letter: The intervention is a letter that describes the Schedule II prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| 9 months |
| 30-day Equivalent Prescribing of Schedule II Controlled Substances | 1 year |
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| NOT COMPLETED |
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This baseline measure data was not collected
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| ID | Title | Description |
|---|---|---|
| BG000 | No Informative Letter | This is the control arm and it involves no contact with the prescriber |
| BG001 | Informative Letter | This is the treatment arm; prescribers in this arm receive an informative letter (called a comparative billing report or peer activity report) Informative letter: The intervention is a letter that describes the Schedule II prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Data for Baseline Measures were not collected | years | |||||||||||||||||||
| Sex: Female, Male | Data for Baseline Measures were not collected |
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| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | 30-day Equivalent Prescribing of Schedule II Controlled Substances | The prescribing of schedule II controlled substances over the 3 months following the initial sending of the letters. Prescribing is defined as the total "days supply" of schedule II controlled substances attributed to the prescriber, expressed in "30-day equivalents" i.e. divided by 30. | Posted | Least Squares Mean | Standard Deviation | 30-day equivalent prescription fills | 3 months |
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| Secondary | 30-day Equivalent Prescribing of Schedule II Controlled Substances | Posted | Least Squares Mean | Standard Deviation | 30-day equivalent prescription fills | 1 month |
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| Secondary | 30-day Equivalent Prescribing of Schedule II Controlled Substances | Outcome measure not collected for study | Posted | 6 months |
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| Secondary | 30-day Equivalent Prescribing of Schedule II Controlled Substances | Outcome measure not collected for study | Posted | 9 months |
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| Secondary | 30-day Equivalent Prescribing of Schedule II Controlled Substances | Outcome measure not collected for study | Posted | 1 year |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | No Informative Letter | This is the control arm and it involves no contact with the prescriber | 0 | 758 | 0 | 758 | ||
| EG001 | Informative Letter | This is the treatment arm; prescribers in this arm receive an informative letter (called a comparative billing report or peer activity report) Informative letter: The intervention is a letter that describes the Schedule II prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers. | 0 | 760 | 0 | 760 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Adam Sacarny | Columbia University | 212 305 7084 | ajs2102@columbia.edu |
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